CONCEPT OF KIDNEY DISEASE IN UNANI LITERATURE-A REVIEWHTML Full Text
CONCEPT OF KIDNEY DISEASE IN UNANI LITERATURE- A REVIEW
Md. Shafat Karim * 1, M. A. Kalam 2, Md. AnzarAlam 3 and Khurshid Alam 4
Government Tibbi College 1, Patna - 800003, Bihar, India.
Department of Ilmul Advia, A.F.U.M.C 2, Indore - 453771, Madhya Pradesh, India.
National Institute of Unani Medicine 3, Bengaluru - 560091, Karnataka, India.
APHC Jarang 4, Vaishali - 844111, Bihar, India.
ABSTRACT: Kidney is a vital organ of the human body which performs the very important function of formation of urine. Unani system of medicine has illustrated its anatomy, physiology and diseases occurred due to its different abnormalities. Kidney has the four common powers viz; Quwwate Jazibah (absorptive power), Quwwate Hazimah (digestive power), Quwwate Masikah (retentive power) and Quwwate Dafiah (power of excretion) and one special power Quwwate Momaiyazah (power of discrimination) which is responsible for the normal functioning of the kidney. Quwwate momaiyazah is mainly responsible for the separation and discrimination of the waste constituents come with blood, and finally makes the urine. Kidney has four types of disease like Amraz Sue Mizaj, Amraz Sue Tarkeeb, Amraz Sudda, and Amraze Tafarruque Ittesal. All the diseases regarding kidney come under this at least one of the four headings. Understanding of Unani physiological aspect and disease condition of the kidney will pave the path of its prevention and cure.
Kidney, Unani concept, Disease, Quwwate Momaiyazah
INTRODUCTION: Kidney is a muscular organ placed on both side of the vertebra on the ventral aspect of the body. This particular type of muscular organ is needed to differentiate the water from the whole blood for absorption. The structure of kidney is very compact, by which it can absorb the watery constituents of the blood and during the elimination of the urine it will be stable and not to be altered by passing the toxic or any harsh matter through it. Its color is red because this color is appropriate for the absorption of the blood. Its shape is made elongated for more absorption. Its convex part is kept outside, so as it gets protected from the trauma and concave part is kept inside, as this place is already protected 1, 2, 3.
The liver performs a great job of changing the chyme into the blood. This function can’t be performed by the liver without water, because water is mixed with the chyme, make into liquid and able to penetrate in the narrow path of the canaliculi of the liver. When the nuzj of the chylous matter completes, then it produces some “fuzla” which it has to be excreted out. During the process of nuzj, the liver produces three types of “fuzlat,” one is “Raghwah” i.e., “foam” which is absorbed by the gall bladder, the second is “telchat” i.e., argols, which is absorbed by the spleen, and for absorption of these matters, the liver assists them. And third is bol (urine), in the same manner, the liver assists the kidneys for the absorption of the watery recrement. Kidneys harvest its food matter from the butteriness of the blood and after that watery part is left for the elimination as urine 2, 4.
Kidney has the four common and one special power which is responsible for the normal functioning of the kidney. These powers are; 5
- Quwwate Jazibah
- Quwwate Hazimah
- Quwwate Masikah
- Quwwate Dafiah and
- Quwwate Momaiyazah
Out of these five powers, three powers (viz. Quwwate hazimah, Quwwate masikah and Quwwate momaiyazah) are important for the maintenance of the normal composition of urine. Quwwate hazimah provides nutrition to the kidney from blood which comes towards it. Quwwate masikah holds the maiyat up to a certain period, in which the organ efficiently pick up the food material passing through it. Quwwate momaiyazah is mainly responsible for the separation and discrimination of the waste constituents come with blood, and finally makes the urine. If Quwwate hazimah becomes poor, blood containing food which comes to the kidney will not be picked up by them, and ultimately it eliminates via urine. If quwwate masikah becomes weak, kidneys will not be able to hold the “maiyat” (which is prior to the urine) and eliminate with urine. This sudden loss of “maiyat” deprived the kidney and it cause further absorption of the blood and this cycle continues. In third and last condition, when the Quwwate momaiyazah becomes poor, then the kidney is not able to discriminate the matter containing in “maiyat.” In this condition, they leave some important substances, which should have been reabsorbed. This power of separation is responsible for the ultrafiltration and reabsorption in kidney.5
Diseases of the Kidney: Four types of kidney diseases are described by an ancient physician; these are:
Amraz Sue Mizaj: Normally, the mizaj (temperament) of the kidney is har ratab (hot and wet). If any deviation in the mizaj occurs, it produces the disease condition of the same type. This may be (i) Sue mizaj har (hot), means when the hot temperament of the kidney exceeds to its own normal hot temperament, (ii) Sue mizaj barid (cold), normally kidney hasn’t cold temperament, if it becomes less hot than the normal, it is a diseased condition. (iii) Sue mizaj ratab (wet), normally it is wet, but in case of exceeding its normalcy, it becomes diseased. (iv) and Sue mizaj yabis (dry) when the temperament of the kidney changes towards the yaboosat, it is a diseased state. 6, 7
Amraze Sue Tarkeeb: In this condition, normal structure of the kidney is altered. Sometimes size of the kidney shrinks, and sometimes it increases from normal size 7.
Amraze Sudda: Sudda (obstruction) can occur in any part of the kidney, which may be due to stone, blood clot, extra cell growth, etc. and produces disease in the kidney 7.
Amraze Tafarruque Ittesal: This disease of the kidney occurs due to any types of wound or rupture of the vessels or any derangement in its mass. Example of this kind of disease is quroohe-kulliyah (renal ulcer), aakla (cancrum), or any rupture of the vessels. These diseases sometimes occur in the body of the kidney and sometimes in its tubules. When kulliyah (kidney) is exposed to many diseases, it leads to the weakness of the liver and its sequel is finally ascites 7.
Some physicians described the kidney diseases in another way which is as follows: 8
- Sue mizaj kulliyah
- Warme kulliyah
- Hesate kulliyah
- Wajae kulliyah
- Huzale kulliyah
- Iltehabe hauz kulliyah
- Sudade kulliyah
Amraze Sue Mizaj: Kidney affected by the temperament, (like har, barid, ratab or yabis). Among har, barid, ratab or yabis, any one of the temperament alters from normalcy, it causes the disease of the kidney of that particular sue mizaj. Hararat (hotness) perform the responsibility of absorption and filtration of blood in the kidney. In the case of sue mizaj har, hararat of kidney augment, and resulting increase in absorption of blood. In this condition, absorption and filtration of the kidney increases, this makes a large volume of urine and leads to polyuria. Due to hararat color of urine becomes reddish or yellowish and burning micturition occurred. While excessive buroodat weakens the absorptive power, and excessive ratoobat weakens the absorptive power as well as retentive power. On the other hand, yaboosat enhances the absorptive power and resulting in further absorption of blood and its filtration. This process occurs rapidly as a result of which kidney failed to hold the blood and its filtrate for concoction as well as to pick up the nutrition from the blood 7.
Zoafe Kulliyah: It is one of the disease condition of the kidney, which may occur due to one of the sue mizaj. The weakness of the kidney occurs in its muscular part, which is mainly responsible for the absorption and filtration of the blood. Although vessels, ducts, and pores are being healthy or a bit it may be deranged, i.e., it becomes widened. Filtration and reabsorption of blood don’t occur properly. The filtrate contains blood stain and nutritious matter, and urine seems like ghassalah (wash of fresh meat). This ghassalah is nothing but RBC’s, proteins and other constituents of blood, which has to be filtered. These constituents cross the filtration barrier, due to the weakness and large sized pores of the kidney 7. When albumin doesn’t reabsorb or not separated by the kidney, then it lost with the urine, and in this condition the whole body becomes oedematous 9.
Majoosi says that sometimes blood stained/ mixed micturition occur. Its cause may be intrinsic or extrinsic. It may be due to the weakness of quwwate momaiyazah. This power can’t transform or segregate the “maiyate dam” efficiently. Sometimes these types of micturition may be due to the weakness of quwwate masikah, which acts in the narrow vessels and channels of the kidney and hold the blood for a certain period. Due to its weakness, the blood does not hold there and eliminate with the urine. There is also a possibility of the expansion of the narrow vessels or barrier, which filter the blood. As a result, a large volume of urine passes out mixed with blood. There is no feeling of pain by the patients, or if they sometimes feel pain, the intensity is very mild 1.
Razi states in Al Mansoori that when oliguria or anuria occurs and the patient does not complain of pain or heaviness in the loin region, immediately treat with diuretic drugs; otherwise ascites will develop 10.
Disease of the kidney generally does not heal itself; also its treatment becomes tough, due to its compact structure and continuous function. The Unani physician described several causes which hamper the smooth treatment of the kidney disease. These are as follows:
- The kidney is the passage of urine and other waste products; therefore, the drugs intended to be effective do not stay at the site of action for a sufficient period.
- The matrix of the kidney is made up of too hard and complex mass; therefore, the drug did not diffuse easily to the site of action.
- The waste material excreted by the kidney is usually of harsh and corrosive, which delay or partially hamper the process of healing. Kidney always remains busy in their work, while the healing process requires a degree of rest. 3, 5, 8, 11, 12
CONCLUSION: Classical Unani literature already has a detail description of the whole body in the form of its kulliyat. It is the need of the day that we should elaborate this in the present extent and also with the help of modern tools. The unani system has an enormous number of drugs which is used in various disorders, but these are still not in use unless these are not described in the diseased aspect. Because the drugs advised for the various ailments are totally based on Unani Kulliyat, therefore it becomes necessary to reveal these concepts, by which physician may apply in these days.
ACKNOWLEDGEMENT: I acknowledged those whose papers, articles, books are cited for this.
CONFLICT OF INTEREST & FUNDING: Nil
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How to cite this article:
Karim MS, Kalam MA, Alam MA and Alam K: Concept of kidney disease in Unani literature- a review. Int J Pharmacognosy 2015; 2(9): 444-47. doi: 10.13040/IJPSR.0975-8232.2(9).444-47.
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